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1306 BELFAST AVE - Building Permits
is--, ,. lib CITY OF COSTA MESA � 4y ,i BUILDING DIVISION PERMIT NUMBER DEVELOPMENT SERVICES DEPARTMENT . • PERMIT ' mom- 99-00372 (714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626 PLUMBING PERMIT Job Address: 1306 BELFAST AV Status: ISSUED Suite No Applied: 07/06/1999 Issued: 07/06/1999 Vicinity: . A Parcel Nunmber: 14103905 ISSUED BY: ILII/` Applicant: NOCK, RON - Address: 11612 KNOTT ST. • - Phone: 714 895-1246 _ GARDEN GROVE , CA Zip: 92841 Owrier.',', NAYES;JERRY-E Address 1306 BELFAST.AVE ' Phone: -• -% COSTA MESA, CA Zip: 92626 Contractor: "NOCK PLUMBING Address: • 11612 KNOTT ST Phone: 714 895-1246 , • •GARDEN GROVE,CA Zip: 92841 , License: 707775 4 \ ` �Arch lEng:� .n'gD Address:, ' I iK�r.' Phone: 1 O fj, (f0 Zip: DATE t� ' Stir(14) y: ` > License: r 0�� 0v SCOPE OF PERMIT WATER HEATER CHANGEOUT. , '• 1 ' FEE SUMMARY ' " AMT QTY AMT QTY - • - AMT QTY ISSUE FEE $22.00 Laundry Tub/Washer $0.00 0 Sump Pump $0.00 0 Backflow irrigation $0.000 Landscape Irrigation $0.00 0 Swimming Pool . $0.00 0 Backflow Preventer $0.00 . " 0 P-Trap - $0.00 0 Trap Primer r $0.00 0 Bathtub $0.00 0 • Pressure Regulator $0.00 0 Urinal $0.00 0 Clarifier System, $0.00 0 . ' Process Piping(per 10 ft) $0.00 0 Vacuum Brkr Bkflow(1-4) /$0.00 0 Connect(Ice,Soda,etc) $0.00 0 • Receptors $0.00 0 Vacuum Brkr Bkflow(5+) ' $0.00 0 Dental Units . $0.00 0 .Septic Tank - $0.00 0 - Wash Basin $0.00 0 Dishwasher $0.00 0 Sewer Cap for Demo $0.00 . 0 Wash Basin Set - $0.00 0 Drain, Floor $0.00 0 Sewer Connect . $0.00 0 Waste and Vent System $0.00 0 . Drain, Rainwater -$0.00 0 Sewer Private Line $0.00 0 Water Closet(Toilet) $0.00 0 . Drain, Roof $0.00 0 Shower $0.00 0 Water Heater/vent $11.00 1 Drinking Fountain $0.00 0 Sink, bar $0.00 0 Water Piping(Inst or Rep.) $0.00 0 Expansion Tank $0.00 0 Sink, commercial $0.00 0 Water Re-pipe $0.00 0 Gas Earthquake Valve $0.00 0 Sink, Floor $0.00 0 Water Service $0.00 0 Gas(1-4 outlets) $0.00 0 Sink, kitchen $0.00 0 Water Softener $0.00 0 Gas(Over 4 outlets) $0.00 0 Sink,service/mop $0.00 0 OTHER $0.00 Gas Repipe $0.00 0 Spa(private) $0.00. 0 VIOLATION $0.00 Gas Service $0.00 0 Spa(public) $0.00 0 PLAN CHECK $0.00 Interceptors(Grease, Oil) $0.00 0 REINSPECTION $0.00 0 Interceptors(Sand Auto) $0.00 0 TOTAL CALCULATED FEES: $33.00 COMMENTS/SPECIAL CONDITIONS • NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord.No.92-28,§ 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections end final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 DECLARATIONS WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: • ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the for which this permit is issued. I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My workers'compensation Insurance carrier and o icy numbs :- Carrier:. to 1 Policy Number: A) - L L 5 ',�b (This section need not be completed if the is valued at one hundred dollars($100)or less.) ❑ I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provisions. Applicant Signature: Date: WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE.INTEREST.AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Cha ter mencing with Section 7000)of Division 3 of the Business and Profgfsior}SCyde,and my license is in full force and effect.Lic.k 7e) "] l Class It C' Contractors Signature: `�i��"""..."` / Date: '7 — 7 Q CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lenders Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): O I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec. 7044, Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec. 7044, Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). O I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. 0 Yes ❑No Driver's License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ..-. _ El hereby cenifyN�hal nwo.excavatlon five{5),or-more feet In depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Adininistrative'Code).� ❑ As owner-builder,I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division?XW C' Signature: , . Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑Yes ❑No .. (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No (Section 25533 of the Califomia Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). o buil.. y hazardous 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes 0 No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully compiled with? 0 Yes 0 No the —..._e-.._._ r___—__ 5 Does or will the applicant or present or future buildingsoccupant at y other for the work which isi the subject age of this application aUP Nnit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes LJ No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No (If"yes",the facilitymust meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No —.__...from..theappopri.___. ________...-_................._. 8 (If"yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for Inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final Inspection. ignatur a al Owner(s) / te And/Or Authorized Applicant Date CODE r INSPECTION TYPE PATE INTIRALS CODE/ INSPECTION TYPE PATE 1NTRIAL6 1616 Fixed System Final Fire Prevention 206 Final Mechanical r� 1266 Pool Spa Final 208 Final Plumbing o-I 1 200 Final Re-Root 210 Final Electrical : 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy 2446.46 • cD CITY OF COSTA MESA BUILDING DIVISION 1 DEVELOPMENT SERVICES DEPARTMENT PE IT NUMBER PERMIT Sb*Pommo se 01-00768 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.usDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 BUIJob Address: 1306 BELFAST AV Status: ISSUED Suite: Applied: 05/29/2001 Vicinity: - RESIDENCE 8 ATTACHED GARAGE Issued: 05/29/2001 Parcel Number 14103905 Zoning: R1 R1 Applicant: YOUNG, RON . ISSUED BY: ___4(=,_ Address: 1207 N CITRON LN . ' -- Phone: (714)635-4912 ANAHEIM, CA Zip: 92801 - Owner: HAYES, JERRY E _ Address 1306 BELFAST AVE - - - Phone: COSTA MESA,CA Zip: 92626 Contractor: CARSON ROOFING AND INSPECTION Address: 1207 N CITRON LN Phone: (714)635-4912 ANAHEIM,CA - Zip: 92801 License: 661526 • - Arch : ' Eng: , — Address: - - . Address: Phone: , Phone: Zip: License: License: - P : SCOPE OF PERMIT., ',''_,'' ",,, REROOF:T/O,REPAIR SHTG AS'NEEDED,.1 LAYER 15#_FELT,APPLY"GAF ROYALtSOVERIGN"COMP SHINGLES. 2300 SQ FT _ - _ ti_ — *'— FEE'SUMMARY7r` Plan Check: . $0.00 -. _ J- , j/'/ -Calc Valuation. i ( $3900.00 ' Permit:, ', .: $97 .25 Claim Valuation:a/7 $3soo'oo SMTP Res: ' $0.50 SMIP-Com:'. ;:,,$0.00 -iiL • .o' ! ' , Kt Other: ' '$0.00 /)//% _ Ins ection' $0'.00 J Total: ' `� s" < >7 , 'N'-''''<1,---,,,,S1----,1 %'PLANNING'S ZONING `/e1 //// SETBACKS ' /7/ ' ",--- r V MAIN STRUCTURE-Front , 0=0 " •'Rear 0-0 - Left 0-0- Right -20-0,/,/ —, ACCESSORY Front ,0--0.. - Rear ` 0=0 Left 0-'0 -;\` )i Right__-;•,">0=0 PARKING Existing: 0— Required: 0 " ' ' Proposed:' 0 J 7 - /---- NOTES: - _ __ NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord.No.92-28,§ 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 244646(6/00) DECLARATIONS n � WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the ork for which this permit is Issued. VAIlhave and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My workers'compensation Insurance carrier and policy number are: Carrier: Policy Number: (This section need not be completed i/the permit is valued at one hundred dollars($100)or less.) ❑ I certify that in the performance of the work for which this permit Is issued,I shall not employ any person in any manner so as to become subject to the workers' compensation laws of lifomia,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these pr Bions.Applicant .p',�¢�/ C WARNING:Signature: ( F`COM Date:RRI NL)- 7 AN-d l FAILURE TO SECURE WORKERS' MPENSATION VERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100,000),IN ADDITION OTHE COST 0 PENSATION,DAMAGES AS PROVIDED FOR IN SECTION 37060F THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect. Lic.# ! Dlassate: # Contractor's Signature: (14Vp/` �(/ Date: S' .D-O 0 CONSTRUCTION LENDING AGENCY: �( ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Cade). Lenders Name: Lender's Address: Signature: Date: • OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): ❑ I.as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or Improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. 0 Yes 0 No Driver's License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person Is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above, unless such person has a permit to do such work from the division. Signature: • Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: I Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds.or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑Yes ❑No (Section 25533 of the Califomia Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes 0 N (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? LJ Yes LJ No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). p.r.of the facility o.... n tr c ed.. 6 Will any pen facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes 0 No (If'yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes ❑No 8 (If yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Signature Of Legal Owner(s) Date � 2-S _ - �D C:� / Antl/Or Authod ApDlicani Date ;ODE• INSPECTION TYPE DATE INTRIALS CODE• INSPECTION TYPE ATF INTRIALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final ( 208 Final Plumbing 200 Final Re-Roof (-7-61 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy 25466 CITY :;c Ui ilicSA COSTA MESA BUILDING-SAFETY DEPARTMENT MAR 21 1966 P.O. BOX 1200 COSTA MESA, CALIFORNIA 92920 . For Applicant to Fill In Completely PLICA •RE111 TYPE OR PRINT • "t � kid .J ABUIDDLD /104 �EL cm,sr NUE Ice-Use n REDHING RECEIPT NO. P[aNIT . COSTA MESA. CALIFORNIA il RECTI /y'� D E R= IVSD ATE I• }D owNeR�i�/�l'll//N 2E I/i9i✓ f'// � l �i(r 2 (n/' MAIL q / ADDRE S,3o /` ' //?,ti 7 /J0 ADDRESS /SO e gELm9�E'j /9dE ADDRR88 F7 Lr/�/tf /�/ FIREr____ y TEL ZONE TYPE GROUP cITY CpSTfl / ESi1 No.SYSs6/7 6' t ARCHITECT' TEL. BYPROVQD I QC DATE =)/2( QC, OR ENGINE)/ NO. L 1 • ) ZONING ADDRESS (/K p Z/Q(�IE / No.or I.USE OP NEW ye/P/ CONTRACTOR.0/4M/0 R` LJIRi,DE/� „ I�/P,LLANS / BUILDING ��Lje / LEGAL " t t' 74 z C7( ADDRESS • +1/-- C CITY A.P.NO. Q3 —, NOTE: NO EAVE OVERHANG SHALL BE LESS THAN STATE TEL 80'TO SIDE B REAR P•L. LIC.NO. NO. SIZE �,/ EAVES OF LOT / 3 x ode I nooOP oe°wGS. ALLOWED (U.B.C.REQUIREMENT) YARDS APPROVED YARDS APPROVED USE OF MAIN BUILDING ACCESSORY BUILDING EXISTING BLDG. �CLA{� { G�(' e SETBACK LINE PROM - FRONT/r 0FT1)� 7"'j eve PT. CENTER OF STREET REAR YARD T, SIDE YARD I LEFT I RIGHT R.GIDE Fr. a FT. t DESCRIPTION OF WORK L.SIDE Z`7 PT. Fr. - NEW ALTERATION _ ADDITION / REAR�f FT. — FT. DISTANCE BET. BET.MAIN& REPAIR MOVING DEMOLISH MAIN BLDGS. ACCESS.BLDGB. VAR.* DATE BUSIZE • ROOMS STORI C.U•P•AF APPROVED EXTERIOR WALL rT ROOF .AFFROV 0�� —/7—a COVERING I COVERING (A/ �� 3 DATE USE OF BUILDING AND WORKSO BE PERFORMED (YOilk-RC.D° fli9T/0 -.- 2 I HERESY ACKNOWLEDGE THAT.I NAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS POR THE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO CMS PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. PLY WITH ALL CITY ORDINANCES D STATE LAWS LATINO VALUATION CO a BUILDING CONSTRUCTION. SIGNATURE IGN P. PERMTUR OF /'/, ,. /Jam PERMIT FEE 5 N $ 300 ' PLAN CHECK $ W AUTHORIZED AGENT TOTAL FEE $ .3' OWNER LE VAN, DARWIN DATE j-21.-bb JOB ADDRESS 1306 Belfast Avenue BUILDING PERMIT NO. 251+60 GENERAL CONTRACTOR Owner-Builder DESCRIPTION OF WORK Patio Cover AP No. 141-09i9-146 LOT TRACT FIRE ZONE VALUE $300.00 INSPECTIONS I Signature Date GROUP 3 TYPE V ZONE R-1 Soil PERMITS ISSUED Gas SUBCONTRACTOR I Date I Number I Signature Water Plumbing Rough Plumbing Prop. Swr. Line 0 House Con.,0 Sprinkling System Miscellaneous _ Rough Heating and Air Conditioning Temporary Service or Pole Underground 0 Power 0 ' Rough Wiring Heating and Vent. Trenches 0 Forms C Steel Reid. 0 Floor System Bond Beam 0 Steel Reinforce 0 Sheathing Frame and Flashing Lathing— In 0 Out 0 Plaster, Brown Coat Structural, Final Electric Heating, Vent., Refrig. and A.C., Final Plumbing, Final and Gas Test 0 _ Electric, Final / _ Building, Final /eA 1./5-& • ,.,' � i• EE RECEIVED • 8031 � IIIa�1st =- COSTA MESA BUILDING DEPARTMENT FINANCE DEPT. P.O. BOX 3 I7 CITY OF COSTA [VESA COSTA MESA. CALIFORNIA FOR APPLICANT TO FILL IN APPLICATION FOR PERMIT BUILDING ADDRESS 1306 Belfast Avenue BUILDING COSTA MESA. CALIFORNIA FOR OFFICE USE ONLY RECEIPT NO. P�+/�p� OWNER COLLEGE MESA COMPANY . . ©'Uc I RECEIVED BY DATE RECEIVED . DATE ISSUED MAIL ADDRESSP.O. Box 2277, Brookhurst Station , —n-u-er/ /j%f -cal NOV 2 0 1958 CITY Anaheim TNo. KE 3-3161 ADDRESS G ARCHITECT Bulot, Quigley LIC. COSTA MESA. CALIFORNIA OR ENGINEER and Clark. NO. RE 7191 . ADDRESS 1102"1?:'I-17Ch St• , Santa Ana FIRE ZONE ZONENO.OF TYPE U/ GROUP The D[ CITY LIC. �7 PLANS ' , /Ely CONTRACTOR 1uE Hale Company NO. 7350 11 TEL APPROVED I ADDRESS 1777 W.Lincoln Anaheim°.KE 3-3161 BY DATE LEGAL CORRECTIONS DESCRIPTION NO. 46 1 BLOCK TRACT 2671 Plan #4=AR A.P.NO. ' SIZE 64 100 NO.OF BLOCS. X OF LOTNOW ON LOT None I USE OF EXISTING BLDG. SETBACK LINE FROM311 CENTER OF STREET 50 REAR YARD SIDE YARD RIGHT 8' LEFT 71 • DESCRIPTION OF WORK NEW X I ALTERATION I ADDITION REPAIR I MOVING I DEMOLISH BUIL DING 1440' -Gar. ROOMS }'5 STORIES 1. EXTERIOR WALL E, ROOF COVERING DtuCCO COVERING Compo. USE OF NEW BUILDING Single dwelling w/att. garage • I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING BUILDING CONSTRUC. . TION. COLLEGE MESA COMPANY VALUATION SIGNATUR PERMIT FEE S 30.00 PERMITTE • . THE HAT.R (;,/O7//[M/raNY GP r r CO je $ 12,599 PLAN CHECK 5 15.00 /_ '�Q��1/,d��/� ', TOTAL FEE $ 45.00 �e:r OWNER COLLEGE MESA COMPANY DATE 11-20-58 JOB ADDRESS 1306 Belfast Avenue BUILDING PERMIT NO. 8031 GENERAL CONTRACTOR The Hal t= Company VALUE $ 12 599.00 AP. No. / LOT 46 TRACT 2671 FIRE ZONE DESCRIPTION OF WORK Res. w/att. gar. GROUP I & J TYPE V ZONE R1 PLAN NO. . INSPECTIONS PERMITS ISSUED DATE NUMBER Trenches Forms Steel .A!Wel Mtn Floor System S't-. . Steel Reinforce Chimney Re-Rod - Bond Beam 1..- lagia Frame and Flashing in C ,IT -4 ;-if Lathing, In Out ^:/t- h -I 9 -. 'Q Plaster, brown coat A a `R d ,$ t Underground soil 4.1-/S WIG Pipe Tes fflg X-. S - Top Out er-24.mp Furnace ';,"_ O 'rail7 .�tI Gas Vents /.215W21111111 - Rough Plumbing ' Il'.fi' S1MEES Mil:IJfl Cesspool Septic Tank r Prop. Swr. Line House Con a.tM �, anNI , Sprinkling System - Heating Final -A 3-/D- -aMIIMM=MME 111111111S11 Y, Plumbin Fixtures, Final �wr \] ' Yt Final Gas Test /{j- /W 2_MG-h' at \I Construction Pole Underground Power Rough Wiring MAW _/Ji)_- , y' EN�= Fixtures, Final nalill - OCCUPANCY gi. - -/A-6i 1 Form 210-5M-1-57 -